Persistent Chalazion: Causes and Treatment Options

Q: Persistent Chalazion: Causes and Treatment Options

Hello： If the swelling does not subside for a long time, it may develop into a granuloma. <br>If topical medication does not completely eliminate it but there is no discomfort, it may not require treatment. <br>However, if there is a feeling of pressure or if it affects your appe

The chalazion granulation has not completely resolved?

Recently, I noticed swelling and pain in the lower eyelid of my right eye when blinking, along with a granuloma-like bump.
I visited an ophthalmology clinic, where it was diagnosed as a pre-sty (hordeolum).
After using prescribed eye drops for a few days, a pus head still developed, so I returned to the clinic for drainage.
After the procedure, the sty was no longer painful, but a small granuloma has persisted for over a month without complete resolution.
During this time, I experienced a corneal abrasion, which led to a change in medication.
The doctor prescribed eye drops and ointment containing aminoglycoside antibiotics and steroids.
Upon researching, I found that this combination is also used for chalazia, which raises the question: could this have transformed into a chalazion, or is it simply residual granuloma from the sty that hasn't fully absorbed (noting that this time it is indeed larger than my previous experience with a sty)? If the swelling does not completely resolve with medication, is surgical excision the only remaining option? The granuloma is mostly asymptomatic, with only occasional mild itching.

Nìmíng, 20~29 year old female. Ask Date: 2021/08/03

Dr. Gao Pilin reply Ophthalmology

Hello: If the swelling does not subside for a long time, it may develop into a granuloma.
If topical medication does not completely eliminate it but there is no discomfort, it may not require treatment.
However, if there is a feeling of pressure or if it affects your appearance, you may consider excision.
Online responses should only be used as a reference; it is essential to seek medical attention at a healthcare facility if necessary.
Gao Pi-Lin.

Reply Date: 2021/08/03

More Info

A chalazion, often confused with a stye (or hordeolum), is a common eyelid condition characterized by a painless lump or swelling in the eyelid due to the blockage of the meibomian gland. Understanding the causes and treatment options for a persistent chalazion is essential for effective management.

Causes of Chalazion
Chalazia typically develop when the meibomian glands, which secrete oils that help lubricate the eye, become blocked. This blockage can occur due to several reasons:
1. Inflammation: Conditions such as blepharitis (inflammation of the eyelid) can lead to the blockage of these glands.

2. Infection: While a chalazion itself is not an infection, it can follow an infection like a stye, which may cause inflammation and subsequent blockage.

3. Skin Conditions: Conditions such as rosacea or seborrheic dermatitis can contribute to the development of chalazia.

4. Poor Hygiene: Inadequate eyelid hygiene can lead to the accumulation of debris and bacteria, increasing the risk of blockage.

Treatment Options
The treatment for a chalazion often depends on its size, symptoms, and duration. Here are some common approaches:
1. Warm Compresses: Applying a warm compress to the affected eyelid for 10-15 minutes several times a day can help soften the hardened oil and promote drainage. This is often the first line of treatment.

2. Topical Medications: In some cases, your doctor may prescribe antibiotic ointments or steroid drops to reduce inflammation and promote healing. The combination of aminoglycoside antibiotics and steroids you mentioned can be effective in reducing inflammation and preventing secondary infections.

3. Surgical Intervention: If a chalazion persists despite conservative treatment, surgical options may be considered. This typically involves a minor outpatient procedure where the chalazion is incised and drained. Surgery is usually recommended if the chalazion is large, causing discomfort, or affecting vision.

4. Injection Therapy: In some cases, corticosteroid injections can be administered directly into the chalazion to reduce inflammation and promote resolution.

Persistent Symptoms and Considerations
Given your description, it seems that the initial stye has resolved, but the residual lump may indicate a chalazion that has formed as a result of the blockage. The fact that it has persisted for over a month suggests that it may not simply be residual inflammation from the stye but rather a true chalazion.

If the lump is not painful and only occasionally itchy, it may not require immediate surgical intervention. However, if it continues to grow, becomes painful, or affects your vision, it would be prudent to consult with your ophthalmologist for further evaluation and potential surgical options.

Conclusion
In summary, a persistent chalazion can arise from various causes, including previous infections, inflammation, and skin conditions. Treatment typically starts with conservative measures such as warm compresses and topical medications. If these do not yield results, surgical options may be necessary. It’s important to maintain good eyelid hygiene and follow up with your healthcare provider to monitor the condition. If you have any concerns about the lump or if it changes in size or symptoms, do not hesitate to seek further medical advice.

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